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What would you do in this situation? - Printable Version

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What would you do in this situation? - dugdale - 11-11-2017

Diagnosed with OSI about two years ago with an AHI of 56

I've been on CPAP therapy for almost two years and have no issues with sleeping whilst wearing the mask. My AHI has been very good, generally less than 1.5 and I usually get at least 8 hours sleep a night.

Over the last 12 months I've lost about 150 pounds and recently had another sleep study with the following results
AHI                             9.6
ODI                           10.4
snoring index              12%
sP02                          91.2%

The letter that I received today has invited me back to discuss these results as they would indicate that I no longer require CPAP therapy as the apnea is considered mild. The letter mentions returning my CPAP machine if I'm happy to do that which suggests that I might have a choice of continuing treatment.

I'm in two minds what to do next as I've tolerated CPAP therapy quite well and an AHI of 9.6 sort of scares me after having such low figures for the last two years. On the other hand it would be quite nice being able to sleep "unconnected" again.

As I live in the UK there is no financial cost involved in me using the CPAP machine.

What would you do if you were in my situation?

RE: What would you do in this situation? - ajack - 11-11-2017

change doctors, they say an AHI over 5 needs a cpap

RE: What would you do in this situation? - dugdale - 11-11-2017

Thanks ajack but that's not really an option.

Being in the UK my sleep apnea is managed in the local hospital rather than by a GP (general practitioner) and there is only one hospital in the city in which I live.

From the NHS website
The severity of OSA is determined by how often your breathing is affected over the course of an hour. These episodes are measured using the apnoea-hypopnoea index (AHI).
Severity is measured using the following criteria:
  • mild – an AHI reading of 5 to 14 episodes an hour
  • moderate – an AHI reading of 15 to 30 episodes an hour
  • severe – an AHI reading of more than 30 episodes an hour
Current evidence suggests treatment is most likely to be beneficial in people with moderate or severe OSA. However, some research has suggested treatment may also help some people with mild OSA.

I wouldn't be surprised if there were different ideas about treatment dependant on which country patients live in.

RE: What would you do in this situation? - Koolbreeze - 11-11-2017

I just recently got put on CPAP by a pulmonologist after a sleep study showing an AHI of 5.3 with no centrals. I wander if your insurance is the driving force behind it being optional.

RE: What would you do in this situation? - Walla Walla - 11-11-2017

I would stick with the machine. If they take it back I'd buy one on my own. Even though your API is below 10 that's still at a level that will disrupt your sleep. Also even though you've lost weight Sleep Apnea gets worse as we get older. So if you were to go off the machine you more than likely would end up on it again.

ajack,
Many Countries are starting to consider under 10 API as not needing treatment now. It's all about the money.

RE: What would you do in this situation? - ajack - 11-11-2017

They can half the NHS treatment cost by raising the bar from moderate to severe. More cost saving ideas to follow Smile

Buy you own cpap, I wouldn't stop using it. There may not be much of a secondhand market there, as NHS provide them. You may need to import from the EU or USA, EU postage will be cheaper and there are always good secondhand ones around, up to 50% don't use cpap after a year.

RE: What would you do in this situation? - Spy Car - 11-11-2017

If the NHS will allow you to keep the machine, that's what I'd do.

If they wanted to confiscate it, there would be a row. If I lost the battle, I'd get my own machine.

I would not go untreated after years of success and an untreated AHI of 9.6.

Bill

RE: What would you do in this situation? - robermax - 11-11-2017

How about sleeping without CPAP for a night or a few to see if you feel any different and make that part of your decision?

RE: What would you do in this situation? - Kryogen - 11-11-2017

My ahi was around 5 with a RDI of 12.
I feel a ton better on CPAP with an ahi under 1 (and can't say for the RDI as you need a sleep study), but it's probably better.

I have way more good days and much less bad days now.

So, considering that I got on cpap with an ahi of 5, I wouldn't quit at 10.

But the suggestion is good, try a week without it, and see how you feel.

And, grats for the weight loss. Incredible, from 56 to 10 with the weight loss alone. That's the best cpap you can get.

RE: What would you do in this situation? - HalfAsleep - 11-11-2017

I have an AHI for insurance purposes of 5 (4% desat). I qualify for coverage. Looking at how bizarre my breathing is while sleeping, I can't imagine ever going off CPAP.

I had an event of 77 seconds during my sleep study and there wasn't a 4% desat, so it didn't count in AHI for insurance purposes. I regularly have 40+ second events. No way I shouldn't do whatever it takes to stay on treatment.

You could try looking at the "Event" tab on Sleepyhead to see exactly how long your AHI events are. Click on them so you can see the wave forms. And/or look at wave forms and see if you're struggling without generating AHI events. Post some here to get input.